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李冰洁,张春阳,徐昕.2型糖尿病尿微量白蛋白与颈动脉粥样硬化的关系[J].同济大学学报（医学版）,2014,35(4):114-117. [点击复制]
LI Bing-jie,ZHANG Chun-yang,XU Xin.The relationship between microalbuminuria and carotid atherosclerosis in type 2 diabetes[J].同济大学学报（医学版）,2014,35(4):114-117. [点击复制]

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2型糖尿病尿微量白蛋白与颈动脉粥样硬化的关系
李冰洁¹,张春阳²,徐昕¹
0 字体:加大+\|默认\|缩小-
(1.同济大学附属同济医院住院医师规范化培训科,上海200065;;2.同济大学附属同济医院内分泌科,上海200065)

摘要:

目的探讨2型糖尿病患者尿白蛋白水平与颈动脉粥样硬化的关系。方法选择住院的2型糖尿病患者219例，根据尿白蛋白/肌酐比率分为正常白蛋白尿组（A组），微量白蛋白尿组（B组），大量白蛋白尿组（C组）。比较三组之间颈动脉内膜厚度及颈动脉粥样斑块的面积及发生率。应用统计学分析颈动脉内膜-中层厚度(intima-media thickness, IMT)与糖尿病患者年龄、病程、体质量指数（body mass index, BMI)、血压（blood pressure, BP)、空腹血糖（fasting blood glucose, FBG)、糖化血红蛋白（glycosylated hemonglobin, HbAlc)、尿白蛋白（urinary albumin, Alb)、肌肝（creatinine, Cr)、总胆固醇（total cholesterol, TC)、三酰甘油（triglycerides, TG)、高密度脂蛋白胆固醇（high density lipoprotein cholesterol, HDL-C)及低密度脂蛋白胆固醇（low density protein cholesterol, LDL-C)间的关系。结果C组IMT高于B组（P<0.05)，而B组高于A组（P<0.05)，差异均有统计学意义。C组颈动脉粥样斑块发生率（79.4%)高于B组（65.67%),B组颈动脉动脉粥样斑块发生率（65.67% )高于A组 (44.24%),三组间差异有统计学意义（P<0.05),三组间颈动脉粥样硬化斑块大小差弃无统计学意义（P>0.05)。IMT与年龄、糖尿病病程、BP、尿白蛋白/肌酐、TC、TG正相关，与BMI负相关。结论2型糖尿病患者出现微量白蛋白尿时发生颈动脉粥样硬化和大血管并发症的可能性增加。患者年龄、糖尿病病程、血压分级、Alb、TC、TG是影响2型糖尿病患者颈动脉IMT的危险因素。

关键词: 2型糖尿病尿微量白蛋白颈动脉粥样硬化斑块颈动脉内膜-中层厚度

DOI：10.3969/j.issn1008-0392.2014.04.025

基金项目:

The relationship between microalbuminuria and carotid atherosclerosis in type 2 diabetes

LI Bing-jie¹,ZHANG Chun-yang²,XU Xin¹

(1. Section for Residency Training, Tongji Hospital, Tongji University, Shanghai 200065, China;;2. Dept, of Endocrinology, Tongji Hospital, Tongji University, Shanghai 200065, China)

Abstract:

Objective To study the relationship between microalbuminuria and carotid atherosclerosis in type 2 diabetes. Methods Two hundred and nineteen patients with type 2 diabetes were enrolled in this study. The value of urinary albumin/creatinine ratio was used to evaluate albuminuria. There are normal urinary albumin group ( A group)，micro-albuminuria group ( B group)，macroabu-minuria group(C group). The relationships between intima-media thickness(IMT) and albuminuria( Alb), age，duration，creatinine，total cholesterol (TC)，triglyceride (TG)，blood pressure，body mass index hemoglobin (HbAlc) were examined. Results IMT was significantly lower in A group than B group and C group ； IMT in B group was lower than C group (P<0.05). The incidence of carotid atherosclerotic plaques in C group (79.4% ) was higher than B group (65.67% ) , the incidence of carotid atherosclerotic plaques in B group (65. 67% ) was higher than A group (44. 24% ), There was significant difference in the incidence of carotid atherosclerosis plaque among the three groups (P<0.05). There was no significant difference in the size of carotid atherosclerosis plaque among the three groups (P>0.05). IMT in type 2 diabetes correlated positively to the age，diabetes duration, albuminuria，blood pressure grade，total cholesterol，triglyceride，but correlated negatively to BMI. Conclusion Microal-buminuria is related to carotid atherosclerosis in type 2 diabetes. The age, diabetes duration, blood pressure grade, Alb, total cholesterol level, triglyceride level are risk factors of the IMT.

Key words: diabetes microalbuminuria carotid atherosclerosis intima-media thickness